Enhancing the clinical research pipeline: training approaches for a new century.

There is growing concern that the numbers of physician-scientists being trained in U.S. academic health centers will not be sufficient to continue the rate of current progress in biomedical research. The authors believe that the needs of current trainees and junior faculty must be addressed immediately, and that programs to train the next generation of patient-oriented researchers must be established without delay. The authors describe a two-pronged approach to this looming crisis. First is a description of innovative educational programs implemented at one academic health center from the K-12 level through the medical-school curriculum. Second, programs are discussed that have been developed to facilitate the recruitment, training, and retention of physician-scientists in the early parts of their professional careers. Four models of training "translational" investigators are presented, along with case studies of how these models have been implemented in real-life productive and professionally satisfying collaborations within one academic health center. The authors conclude by stating that to be prepared for the effects of future knowledge on human disease and preventive health, academic health centers must enhance training opportunities for physician-scientists.